Postoperative Pain Control using Intravenous Patient Controlled Analgesia in Cesarean Section and Hysterectomy

Abstract

Background: Postoperative pain degree is variable according to the site, type, and method of operation. This study compared the pain degree and amount of analgesics required among 3 types of operation. Methods: Ninety patients were selected that cesarean section (Group I, n = 30), open total hysterectomy (Group II, n = 30), laparoscopic total hysterectomy (Group III, n = 30) were scheduled. Patients received PCA with basal rate 2 ml/h, bolus 1 ml, lockout interval 5 min using fentanyl and ketorolac. We evaluated VAS at 30 min, 2, 6, 12, 18, 24, 36, 48 h postoperatively, demand of button and attempt of button, 6 hourly used amount of analgesics; side effects and degree of satisfaction after 24, 48 h postoperatively. Results: The rest VAS decreased below 30 at 6 hr in group I & II and at 2 hr in group III. More analgesics were needed for the first 6 hr compared with remained time in 3 groups (group I vs. group II vs. group III, P ＜ 0.05). Total amount of analgesics including loading dose were fentanyl 1,536 ± 342μg, ketorolac 167 ± 34 mg for group I; 1,212 ± 215μg, 132 ± 30 mg for group II; 866 ± 125μg, 97 ± 27 mg for group III (group I vs. group II vs. group III, P ＜ 0.05). Conclusions: The postoperative pain was painful as order of cesarean section, open total hysterectomy, and laparoscopic total hysterectomy. The pain was reduced 6 hr in laparotomy and 2 h in laparoscopy. (Korean J Anesthesiol 2007; 52: 166～71)